Laminectomy

What Is a Laminectomy?

Laminectomy is a spinal surgery performed to alleviate pressure on nerve roots caused by several underlying conditions. It involves removing the lamina, the bony arch connected to every vertebra. In complex cases involving spinal decompression or spinal fusion, robot-assisted technology is used for precise results and improved outcomes.

There are several categories of laminectomy, based on the location of the affected area:

• Lumbar Laminectomy: These procedures are performed on the lower back and are the most common form of laminectomy.
• Cervical Laminectomy: Cervical laminectomies are performed on the neck to relieve pressure on the spinal cord.
• Thoracic Laminectomy: These procedures are performed on the mid-back area and are the least common form of laminectomy.

Our spine experts are among the most experienced in the nation. Your personalized treatment plan aims to reduce neck and back pain and restore function, whenever possible. We strive for superior outcomes from diagnosis through treatment and recovery.

Types of Laminectomy

The goal of any laminectomy procedure is to alleviate pressure on the spinal nerves and provide relief for neck, back and leg pain. Our spine specialists have expertise in many types of spine surgery, including forms of laminectomy, such as:

Open Laminectomy

An open laminectomy is a traditional and more invasive form of surgery involving a larger incision and muscle dissection to pinpoint the right area of the spine. Most of the time, surgeons will prioritize less invasive procedures over open surgery, but in certain cases where access to the affected vertebrae is difficult, this type of treatment may be required.

Minimally Invasive Laminectomy (MIL)

Minimally invasive laminectomy (MIL)  is the preferred method of laminectomy due to the use of small incisions, tubular retractors and microscopes, which help guide the surgeons without causing excess damage to surrounding muscle and soft tissue. While recovery time is different for every patient, it is often quicker and smoother after a minimally invasive procedure.

Laminotomy

Laminotomy is a separate but related surgical procedure in which a smaller portion of the lamina is removed, leaving the arch intact. This is a minimally invasive procedure that can help relieve nerve pain in the arms and legs while also maintaining stability without the need for fusion or implants. Laminotomy typically has a quicker recovery period than other more invasive procedures, along with a high success rate. Laminotomy is sometimes performed as an outpatient procedure, though some patients will require a short hospital stay afterward.

How Does a Laminectomy Work?

Laminectomy works by removing the arch of a vertebra or vertebrae in which the disks have been compromised by disease or degeneration. Once the disk begins to break down, it loses its cushioning and shock-absorption properties, allowing the vertebrae to compress the spinal nerves and causing pain in the neck, low back, arms and legs.

Once the vertebral arch is removed, nerve compression is alleviated, which allows for healing and symptom relief.

Depending on the location of affected vertebrae, the surgeon will make an incision in the back or neck and move the muscles in order to access the spine. The lamina is removed, and depending on the case, the surgeon may also remove bone spurs or herniated disk material that is impacting the spinal canal. Once the lamina has been removed, the surgeon will ensure the muscles are returned to their original place and close the incision with stitches or staples.

Laminectomy Success Rates

Laminectomy procedures generally have very high success rates, with more than 75% of patients saying they are satisfied with the long-term results. Immediate satisfaction is even higher, with 85-90% noting they experience significant pain relief within the first six weeks.

While laminectomy failures are rare, there are some factors that contribute to unsuccessful procedures. For example, patients with severe underlying conditions may not experience 100% pain relief. Some patients may also need to have a follow-up surgery if they don’t get the results they expect the first time. As with any surgery, infections, muscle and nerve injury are all possible, though not common.

Trusting spinal experts, like those on the Houston Methodist team, for leading-edge spinal care is a great step in improving your chances of a successful laminectomy.

What Conditions Does Laminectomy Treat?

Laminectomy is recommended as a treatment for many underlying spine issues and conditions, including:

Herniated Disk

Disk herniation occurs when the center of a vertebral disk pushes out through a crack in the exterior disk casing. Bulging disks are very similar, but do not break through the exterior. Both conditions cause shooting or radiating pain through the legs or arms, along with tingling, weakness and numbness as a result of nerve compression.

Osteoarthritis of the Spine

Osteoarthritis of the spine (spondylitis) is an age-related degenerative condition in which the facet joints between each vertebra start to break down. This can sometimes lead to the development of bone spurs, which can place pressure on nerve roots and cause pain, numbness and weakness. Laminectomy is one way to treat the symptoms of osteoarthritis and make more space inside the spinal canal.

Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal caused primarily by age, though it can also be attributed to spinal injuries, congenital defects or scoliosis. Spinal stenosis is categorized based on location, so patients may be diagnosed with cervical, thoracic or lumbar spinal stenosis. Laminectomy may be recommended for patients with severe cases of lumbar stenosis in order to quickly make more space within the spinal canal and alleviate nerve compression.

Spinal Fracture

Spinal trauma or disease can cause compression fractures in the vertebrae, which places more pressure on the spinal nerves, resulting in pain, numbness and weakness.

Laminectomy offers a way to ease that pressure in serious cases for which conservative or non-surgical treatments are ineffective. Because spinal fractures can cause greater instability in the spine, a laminectomy may be paired with spinal fusion for longer-lasting results.

Who Qualifies for a Laminectomy?

Most spine experts will opt for conservative treatments before recommending a surgical procedure. However, if other avenues like physical therapy, pain management and lifestyle changes have not made a difference, they may suggest the most minimally invasive surgery available to get better results for patients.

To qualify for spinal surgery like a laminectomy, the patient will typically need to have an official diagnosis for one of the conditions listed above, and verification of that diagnosis through imaging (MRI, CT scan, X-ray, etc.). Keep in mind that a diagnosis is not the only criterion for laminectomy eligibility. Your spine surgeon will need to make sure there is no less invasive and/or more effective treatment for your diagnosis, and you will need to be in appropriate physical condition to undergo the procedure.

Preparing for a Laminectomy

To prepare for a laminectomy, Yyour doctor will conduct a physical examination and discuss any previous treatment for the condition. He or she may order an X-ray, MRI or other imaging exam of your spine to confirm the location of your spine issues. Follow these steps to prepare in the days or weeks leading up to your surgery:

• Stop taking blood-thinning medications before the surgery
• Talk to your doctor if you have a bleeding disorder
• Let your physician know if you have any allergies or sensitivities to anesthesia, medications or latex
• Follow your doctor’s pre-op instructions to ensure a smooth experience the day of the procedure
• Prepare your home and support network so it is ready for recovery
• Arrange for a driver to transport you home after you’re discharged from the hospital
• Follow directions to stop eating and drinking the night before the procedure

Recovering From a Laminectomy

After the procedure, you will be moved to a recovery room where we will monitor you for complications from surgery and anesthesia. You may feel groggy or “out of it” for several hours after you wake up from anesthesia. This is normal. Most people stay in the hospital for one or two nights.

Plan to take it easy for a while after your surgery. Your health care provider will tell you what to expect based on the surgery and your individual health condition. We may recommend you meet with a physical therapist to learn how to safely conduct daily activities while you heal.

Limit activities that include lifting, bending or stretching for several weeks. You may be unable to drive for one to two weeks. Avoid long car rides or flying in an airplane for at least two weeks after your surgery, if possible, to reduce the risk of blood clots.

Keep the incision site clean and dry to reduce the risk of infection or other complications. Your health care provider will give you showering and bathing instructions.

You may be asked to return in around two weeks to have any stitches or staples removed.

Take a pain reliever for soreness only as recommended by your health care provider.

See your doctor right away if you experience new or worsening pain, a fever over 101 degrees Fahrenheit, or any signs of infection, such as redness or swelling at or near the injection site. 

Across Houston, our patients have access to our expert neck, back and spine specialists so that you can get the best possible care personalized for your needs — without traveling far from home. Explore our footprint of locations in the Greater Houston area and suburbs below.